Please complete the form below to notify CuraLinc Healthcare of a new client with your organization. Your CuraLinc Client Relationship Manager will send a confirmation of receipt within two business days.

Program Effective Date *
Program Effective Date
Client Address
Client Address
Plan Design (Session Model) *
Does the company provide mental health and substance abuse (MHSA) benefits? If so, what is the company's MHSA network(s)?
Is this program an EAP or an MAP?